Iowa Sen. Grassley: Government must confront overuse of health care

Iowa Sen. Charles Grassley pointed to a Miami doctor, who writes prescriptions for Medicaid patients at a rate of 150 a day, seven days a week, in an attempt to show that the government needs to do something about over-utilization of health care.

A Miami psychiatrist who writes prescriptions for Medicaid patients at a rate of 150 a day, seven days a week, has been targeted by a U.S. senator as an example of why the federal government should do more to investigate over-utilization of health care.

The biting letter, from Sen. Charles Grassley, R-Iowa, to federal Medicaid officials comes at a time when authorities are looking for ways to reduce what experts believe is massive overspending in areas like Miami, where health care costs can be more than twice the national average, as healthcare reform advocates look for ways to find the money to spread coverage to the uninsured.

The Grassley letter does not mention Fernando Mendez-Villamil by name, but noted "with alarm" documents from the Florida Agency for Healthcare Administration about a single prescriber who wrote 96,685 prescriptions from the last half of 2007 through the first quarter of 2009 for Medicaid patients.

AHCA records independently obtained by The Miami Herald show that the doctor is Mendez-Villamil, who wrote nearly twice as many prescriptions for mental health drugs as the No. 2 Medicaid prescriber in the state.

The huge number "means that this physician wrote approximately 153 prescriptions each and every day, assuming he did not take vacations," Grassley wrote.

Mendez-Villamil told The Herald he works long hours and sees patients only for 10 minutes every two or three months. Medicaid pays him $45 per office visit. Each patient may require four or five prescriptions, he said, accounting for the large numbers he writes.